Garcia Rodriguez Victor, Grami Zacharia, Laney Jessilyn, Cai Zhenjian, Larson Scott
Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas.
Proc (Bayl Univ Med Cent). 2020 Sep 2;33(4):624-626. doi: 10.1080/08998280.2020.1801322.
Acute esophageal necrosis is a rare cause of gastrointestinal bleeding. Endoscopically, it appears as a circumferential black-appearing mucosa affecting almost universally the mid and distal esophagus. Risk factors include low flow states, malnutrition, alcoholism, and the presence of multiple comorbidities. Prolonged exposure to gastric secretions and direct contact with corrosive agents also induce mucosal ischemia. Sodium polystyrene sulfonate use has been associated with severe gastrointestinal adverse events, including increased risk of small bowel and colonic necrosis and perforation. In susceptible individuals, sodium polystyrene sulfonate can also induce esophageal ischemia and necrosis, as illustrated in this case.
急性食管坏死是胃肠道出血的罕见原因。在内镜下，它表现为环形黑色黏膜，几乎普遍累及食管中下段。危险因素包括低血流状态、营养不良、酗酒以及存在多种合并症。长时间暴露于胃分泌物和直接接触腐蚀性物质也会导致黏膜缺血。使用聚苯乙烯磺酸钠与严重的胃肠道不良事件有关，包括小肠和结肠坏死及穿孔风险增加。在易感个体中，聚苯乙烯磺酸钠也可诱发食管缺血和坏死，本病例即为此例。
